Risk of malignancy in “atypia of undetermined significance” category of salivary gland fine-needle aspiration: A bi-institutional experience

Fatimah Alruwaii, Jen Fan Hang, Bao Rung Zeng, Harvey M. Cramer, Chiung Ru Lai, Carlo De la Sancha, Howard H. Wu

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: Many prior institutional and multi-institutional studies have applied the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) retrospectively to their specimens to determine the risk of malignancy (ROM) of each category. Most of these studies focused on general assessment of the system and risk classification. However, there seems to be less focus on the category of atypia of undetermined significance (AUS) that could be attributed to the low number of cases that could fit into this category. Herein, we present a bi-institutional experience with this category. Methods: A computerized search of the databases was performed to identify all salivary gland fine-needle aspiration (FNA) in two institutions over a period of 12 years. The final diagnosis of each case was reclassified based on MSRSGC, and histology follow-up was retrieved. Results: Sixty AUS cases (out of 1560 salivary gland FNA) were identified with a rate of 3.8%. Forty cases (66%) had a subsequent tissue material. Correlation with histology revealed that the estimated ROM is 37.5% (15/40) and the overall ROM is 25% (15/60). Fifty percent of the cases had a prominent lymphoid component and most commonly represented lymphomas, reactive lymph node or sialadenitis. Conclusion: The AUS category is a heterogeneous group of lesions with predominant lymphoid-rich entities. Some variability exists between institutions with most having higher ROM than the suggested 20% by the MSRSGC atlas.

Original languageEnglish (US)
Pages (from-to)138-143
Number of pages6
JournalDiagnostic Cytopathology
Volume48
Issue number2
DOIs
StatePublished - Feb 1 2020

Keywords

  • Milan system for reporting cytopathology
  • atypia of undetermined significance
  • cytology
  • fine-needle aspiration
  • risk of malignancy
  • salivary gland
  • salivary gland

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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